- What happened and why it matters
- Why California claims handling rules matter after a crash
- Potential implications for California policyholders and crash victims
- Steps to take if a claim is delayed, denied, or underpaid
- Where to get police, DMV, medical, and coroner records
- Key rights and timelines under California law
- Common insurance company tactics that can reduce claim value
- What this enforcement action signals for safety and claims culture
- Why acting now matters
- Commentary from Gosuits California Personal Injury Attorney
- Sources and references
What happened and why it matters
On October 6, 2025, reports indicated that the California Department of Insurance initiated enforcement actions involving Tesla Insurance Services, Tesla Insurance Company, and State National Insurance Company, alleging repeated failures in properly handling policyholder claims and delays in claims responses. The reported statement noted that potential penalties could reach up to $10,000 per violation if conduct is determined to be willful, and that the companies could face suspension of their ability to transact insurance business in California. While further specifics of the allegations were not publicly available in full, the focus on claims handling is significant for anyone injured in a crash who depends on timely, fair insurance benefits for medical care, transportation, wage loss, and vehicle repair or replacement.
California has detailed standards for how insurers must acknowledge, investigate, decide, and pay claims. When an insurer fails to follow those standards, it can cause real hardship for crash victims. Enforcement actions like those described are meant to correct systemic practices and protect consumers, including those with open bodily injury and uninsured motorist claims.
Why California claims handling rules matter after a crash
California’s Fair Claims Settlement Practices Regulations set timeframes and duties for insurers so that injured people and grieving families are not left waiting without answers. Among the key protections:
- Timely acknowledgment and communication. Insurers must acknowledge receipt of a claim within 15 calendar days and provide necessary forms and instructions. They must respond to communications within 15 calendar days. They must keep claimants updated every 30 calendar days on the status of the claim if not yet resolved. See 10 CCR sections 2695.5 and 2695.7.
- Prompt liability decision. After receiving a completed proof of claim, an insurer must accept or deny the claim in whole or in part within 40 calendar days. If more time is needed, it must provide written reasons and continued 30-day updates. See 10 CCR section 2695.7.
- Prompt payment standards. When a claim is settled, payment must be issued within 30 calendar days. See 10 CCR section 2695.7.
- Fair total loss valuations. For total loss vehicles, insurers must follow specific valuation methods and include applicable taxes, license, and transfer fees. See 10 CCR section 2695.8.
- Good faith settlement conduct. California law prohibits unfair claim practices, including misrepresenting policy provisions, failing to adopt reasonable standards for prompt claim handling, and not attempting in good faith to effectuate prompt, fair settlements when liability has become reasonably clear. See Insurance Code section 790.03.
California law also authorizes penalties for unfair claims practices, including civil penalties up to $5,000 per act, or up to $10,000 per willful act, following administrative proceedings. See Insurance Code section 790.035.
Potential implications for California policyholders and crash victims
When regulators scrutinize a carrier’s claims practices, people with open claims understandably worry about delays or disruptions. A few practical points:
- Coverage and claim rights are contractual. If you have an in-force policy and a covered loss, your rights arise under your policy and California law. Regulatory actions typically focus on correcting practices, not canceling existing legitimate claims. For policy-specific questions, check your declarations page and policy booklet.
- Maintain communication in writing. Document all communications. If claims handling slows or becomes inconsistent, written requests for status updates, the basis for delays, and identification of policy provisions can help create clarity.
- Know your state resources. California’s Department of Insurance Consumer Services can help you understand your rights and can investigate complaints regarding claims handling. The Consumer Hotline is 800-927-4357, and there is an online complaint process.
If an insurer’s authority to transact business is suspended or limited, California regulators ordinarily address how existing policies and claims will be handled. Consumers can call the Department of Insurance Consumer Hotline for current guidance tailored to their situation.
Steps to take if a claim is delayed, denied, or underpaid
If you are dealing with injuries or the loss of a loved one after a crash and your claim is stalled or undervalued, consider the following:
- Speak with a seasoned injury attorney first. Before giving recorded statements or signing any medical authorizations for an insurer, consult an attorney for a free consultation to understand your rights. What you say can be used later to limit your claim.
- Preserve evidence. Keep damaged parts, preserve the vehicle until it can be inspected, save dashcam footage, and secure photos, witness contacts, and scene measurements.
- Request a written explanation. Ask the insurer to identify the exact policy provision and facts relied upon for any denial or partial denial. California regulations require clear explanations in writing.
- Demand timely updates. If the claim is not resolved, request written 30-day updates explaining what additional information is needed and why.
- Review all coverages. Check Medical Payments (MedPay), Uninsured Motorist (UM), Underinsured Motorist (UIM), rental, towing, and collision coverages. UM and UIM can be critical if the at-fault driver is uninsured or underinsured.
- Challenge total loss offers. Request the valuation report, comparable vehicles used, and adjustments. California rules require transparent, standardized valuation methods and inclusion of taxes and fees.
- File a complaint when needed. If delays or unfair practices persist, you can submit a complaint to the California Department of Insurance. Provide your claim number, policy number, key dates, correspondence, and the outcome you seek.
Where to get police, DMV, medical, and coroner records
Police traffic collision reports
Police reports help establish fault, document injuries, and preserve scene details. In California, reports are typically available from the investigating agency:
- California Highway Patrol. For crashes investigated by CHP, use CHP 190 to request the collision report. You will need the date, location, and parties involved. See the CHP collision records request page.
- City or county police. If a local agency responded, visit the department’s public records or traffic division webpage for instructions, fees, and eligibility. Each agency has its own process and timelines.
DMV report of traffic accident
California requires drivers to report a crash to DMV within 10 days if anyone was injured or killed or if property damage was more than a statutory threshold. The SR-1 form captures details of the collision. Failure to report can affect driving privileges. See the DMV SR-1 page for current rules and filing options.
Medical examiner or coroner records in fatal crashes
In wrongful death cases, coroners’ and medical examiners’ records can be important. Availability and eligibility depend on county procedures. Examples:
- Los Angeles County Medical Examiner-Coroner. Provides instructions to request reports and records.
- San Francisco Office of the Chief Medical Examiner. Offers a process to request records and reports.
- San Diego County Medical Examiner. Provides information about records and case status.
Death certificates can be requested through the California Department of Public Health Vital Records. The certificate can assist with insurance claims, probate, and benefit applications.
Other helpful records
- Emergency medical records. Request hospital and EMS reports for diagnosis and treatment details. California law allows patients to obtain copies of their medical records, often for a reasonable fee.
- Employer documentation. Wage loss letters, timesheets, and disability accommodation notes can support claims for lost income.
- Vehicle data. If available, preserve event data recorder downloads and software logs. Discuss with counsel before authorizing third parties to access or alter vehicle systems.
Key rights and timelines under California law
Understanding time limits and legal standards helps prevent forfeiting claims:
- General personal injury deadline. Most California personal injury claims must be filed within 2 years of the injury. See Code of Civil Procedure section 335.1.
- Property damage deadline. Claims for damage to personal property generally have a 3-year deadline. See Code of Civil Procedure section 338.
- Government claims. If a public entity may be responsible, a written administrative claim typically must be presented within 6 months. See Government Code section 911.2.
- Uninsured motorist claims. Uninsured motorist coverage rights and time limits are governed by policy terms and Insurance Code section 11580.2. Policies often require prompt notice and may include arbitration deadlines. Review the policy carefully and consult an attorney promptly.
- Unfair claims practices and penalties. California’s Unfair Insurance Practices Act (Insurance Code section 790.03) identifies prohibited conduct. Civil penalties for violations are set out in Insurance Code section 790.035.
- Fair Claims regulations. California’s Fair Claims Settlement Practices Regulations outline communication, investigation, and payment standards for insurers. See Title 10, California Code of Regulations, sections 2695.1 to 2695.17.
Missing a statutory or policy deadline can seriously affect a claim. Consider calendaring all relevant dates early and confirming them with counsel.
Common insurance company tactics that can reduce claim value
While many adjusters work diligently, certain practices can undermine valid claims. Recognizing them can help you respond effectively:
- Requesting broad medical authorizations. Insurers may ask for blanket access to your entire medical history, not just crash-related care. Consider limiting releases to relevant providers and dates after consulting with an attorney.
- Delaying decisions. Repeated requests for the same documents or long periods without updates can be contrary to California’s required timeframes. Ask for written explanations citing the specific regulation or policy provision.
- Recorded statements without context. Adjusters may seek statements before you understand your injuries. Politely defer until after legal consultation to avoid incomplete or harmful testimony.
- Low valuation of total loss. Comparables may be from distant markets or with non-similar options. Request the valuation methodology, comparable listings, and all adjustments. California’s total loss rules provide standards for fair valuation.
- Applying depreciated values to safety equipment. Items like child car seats must be replaced after certain crashes under safety guidance. Ask the adjuster to identify any policy that would limit replacement and provide supporting documentation.
- Prematurely closing claims. Closing a claim before medical stability or while investigations are ongoing can be harmful. Ask for reopening in writing and document ongoing treatment or newly discovered injuries.
- Misstating policy limits or coverage. Ask for confirmation of policy limits and applicable coverage in writing, and request the specific policy language the insurer is relying on.
What this enforcement action signals for safety and claims culture
California continues to confront high numbers of serious traffic injuries and fatalities, which means timely claim payments are a critical lifeline for families. Public data show that traffic deaths in California remain a persistent concern. These losses translate into medical bills, lost wages, and long recoveries for survivors, as well as funeral expenses and profound grief for families. Strong claims handling standards and robust enforcement help ensure that the financial protections people purchase are available when they are needed most.
Regulatory scrutiny of claim practices, whether involving a large automaker’s affiliated insurance entities or any other carrier, signals a commitment to consumer protection. It also serves as a reminder to document claims carefully, use the state’s complaint tools when necessary, and seek guidance so that rights are preserved.
Why acting now matters
The exact thing to do is to organize claim documents, secure critical records, and seek a timely legal consultation before engaging in substantive claim discussions with an insurer.
- Benefit of early action. Acting early helps preserve evidence, prevents missed deadlines, and reduces the risk that statements or partial releases will be used to limit recovery later. Insurers operate on regulatory timelines; clear, documented requests can prompt responses and build a record if later review is needed.
- Urgency. Some windows are short. Government claims may require action within 6 months. DMV crash reporting is due within 10 days in qualifying collisions. Uninsured motorist provisions can include contractual deadlines. Medical documentation is most credible when captured promptly.
- Where and why it matters. In California, Fair Claims regulations create expectations for timely decisions, updates, and payments. Timely consultations help align your next steps with those rules and your policy terms, reducing costly delays and minimizing disputes over valuation and liability.
Commentary from Gosuits California Personal Injury Attorney
To those affected by delayed or mishandled claims, our hearts are with you. Navigating injuries, medical appointments, and vehicle loss while waiting for insurance responses is exhausting. This article is meant for general information and education. It is not a substitute for personalized legal guidance.
From our perspective, reported enforcement actions focusing on claims handling are significant because they go to the core promise of insurance. When a company collects premiums, it must also deliver prompt, transparent claim decisions that follow California’s Fair Claims Settlement Practices Regulations. Allegations of systemic delays are especially concerning where injured people may depend on MedPay, UM or UIM benefits, or timely bodily injury settlements to pay for care and daily needs.
Insurance companies and large corporations understand the complexity of claims, policy language, and procedural rules. They may use delays, broad medical record requests, and carefully crafted questions to shape claim outcomes. That information imbalance can pressure people into accepting low settlements or making statements that do not reflect the full extent of their injuries. Awareness of your rights and the regulatory timeframes is a practical way to guard against these disadvantages.
A free consultation with a skilled personal injury attorney can clarify coverage, deadlines, and strategy. Before speaking at length with an insurer or providing authorizations, consider getting advice about preserving evidence, limiting releases to what is necessary, and requesting written explanations for any delays or denials. Early guidance can help prevent missteps that are hard to unwind later.
Sources and references
- California Department of Insurance – Fair Claims Settlement Practices Regulations (10 CCR sections 2695.1 to 2695.17)
- California Insurance Code section 790.03 – Unfair methods of competition and unfair and deceptive acts or practices
- California Insurance Code section 790.035 – Civil penalties for violations
- California Department of Insurance – File an insurance complaint
- California Department of Insurance – Consumer Services and Hotline
- California Highway Patrol – Collision Records Request (CHP 190)
- California DMV – SR-1 Report of Traffic Accident Occurring in California
- Los Angeles County Medical Examiner-Coroner – Request Records
- San Francisco Office of the Chief Medical Examiner – How to request records
- San Diego County Medical Examiner – Office information
- California Department of Public Health – Vital Records
- Code of Civil Procedure section 335.1 – Two-year statute of limitations for personal injury
- Code of Civil Procedure section 338 – Three-year statute of limitations for property damage
- Government Code section 911.2 – Time for filing claims against public entities
- Insurance Code section 11580.2 – Uninsured and underinsured motorist coverage
